Summer Hospitalization, Part Deux

Yes, I was again in my favorite psych hospital, for 6 days this time. I had a good 4-5 days after the last hospitalization. Strong. Back on track. Feeling good. Still a bit wired, though. But racing thoughts manageable again and suicidal ideation back to a dull roar.

Then I had an anxiety attack on that Thursday as I was getting ready to go to a concert. I was going alone, but knew I would have a great time once I got there. The anticipation of driving 30 miles on routes I didn’t know and to a venue I didn’t know set off high anxiety. I even considered not going.

BUT, using my ACT (Acceptance and Commitment Therapy) skills, I put the anxiety in the back seat and let it ring like an annoying phone and went anyway. The concert was important to me on a lot of levels (i.e., my ex would have loved to go and we would have had fun but I could have fun on my own too). And yes I had an amazingly fun time at the concert! Dancing, yelling, enjoying good, fun music, and memories of discovering the bands for the first time.

I planned the next day just to lay low. I felt like I had a hangover (I had had nothing to drink, mind you). An anxiety hangover. By the end of the day when I went to my friends’ house for dinner, I felt better. Noticed I was still talking quickly and more than usual – for me.

Saturday dawned, I had my monthly massage, I went to a movie I was looking forward to seeing (not an emotional movie), and expected to go to a MeetUp group after the movie. In the middle of the movie, however, I started bawling and had serious suicidal ideation with intent. I focused on the movie as best I could. After the movie, I called my therapist from a quiet place in the theater and went to my car to await her call back. I didn’t feel safe driving, as crashing my car was one of the strongest visions I was having of hurting myself. We agreed that I would call a friend to drive me home to pack for the hospital and a friend would drive me to the hospital. The anxiety was still mixing with the beginnings of mania that had not quite resolved (see Summer Hospitalization).

This time I felt anxious and manic. The doc I see on the inside is a colleague of the doc I see regularly. They used to argue amiably about what meds to put me on and change. It’s a running joke when I show up in the hospital that we are continuing the feud. At least his jokes lighten the mood of our brief consults!

So, increased med for anxiety, increased mood stabilizer for mania. Stir. Wait a few days. Reduce some of anxiety med. Wait a few days. Discharge!

I feel so so so much better! The energy I had after hospitalization a few weeks ago is gone. So I think we got the oncoming mania under control. My anxiety is better medicated to help me come down from the concert anxiety and, I hope, to help me deal with other activities in my life I’d like to take part in but that anxiety is strong enough to keep me away.

An important outcome of these 2 hospitalizations, and the reflection with my therapist in the middle of them, is the reality that I cycle through several moods a year. A rapid-cycling bipolar person has 3 mood shifts a year. I think I have 8?

Early – Mid January – depressed (post-Xmas)

Late January – balanced

February – depressed

Early March – balanced

Mid March – April – depressed

May – June – balanced

Mid July – August – manic

Early September – depressed

Late September – Mid October – manic

Late October – Mid November – balanced (sometimes just hypomanic)

Late November – Mid December – manic

Late December – depressed (post-Xmas)

And the cycle starts again. This has gone on for at least the last 5 years. I can look back further and see many of these shifts most years of my life starting as a teenager. I Am A Rapid-Cycling Bipolar Person! I and my Care Team will have to follow this schedule to adjust meds appropriately and try to avoid hospitalization for the med changes.